We are investigating the effects of prednisolone on the natural history of acute alcoholic liver disease (ALD). In our initial studies, patients with ALD were grouped into three categories based on increasing severity of the disease. Patients in group A all have hepatomegaly, clinically evident jaundice (biHirubin greater than 3 mg/dl) and liver biopsy evidence of acute alcoholic liver disease. Group B patients have in addition to jaundice, hepatomegaly, and liver biopsy evidence of acute ALD, either ascites Or hepatic encephalopathy. Patients in group C have more severe disease with persistent coagulation abnormalities precluding liver biopsy. All patients are hospitalized for 5 to 6 weeks. Assessments are made of mortality, overall morbidity and incidence of side effects during therapy. All patients in groups A and B have liver biopsies before and after the therapeutic trial. Before and after therapy we assess: 1. liver function tests; 2. wedged hepatic venous pressure as an index of portal hypertension; 3. wedged & free hepatic venograms as an index of the status of intrahepatic vasculature; 4. plasma volume by I 125 labeled albumin; 5. fibrogenesis by determination of protocollagen proline hydroxylase on liver biopsy specimens and urinary hydroxproline excretion.